Hard road ahead

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We keep hearing that children are going to school hungry. But what does that mean for their health? Esther Lauaki talks to health experts about the illnesses that go along with low incomes and poor nutrition.

SKIN infections, respiratory problems, obesity and rheumatic fever are among the most common illnesses disadvantaged kids face.

Starship Hospital paediatrician Alison Laversha says the children she sees at hospital are just the tip of the iceberg.

"We see thousands of children, half of those come from Auckland's District Health Board area which includes Tamaki and Glen Innes. The most common reasons for being admitted are injury, respiratory illnesses, pneumonia, bronchiectasis, bronchiolitis and skin infections," she says.

"Different suburbs have different socio-economic profiles and Tamaki-Glen Innes is one area that has more disadvantaged families and we do see many more children from that area than we do from others."

Dr Laversha says kids from deprived neighbourhoods are eight times more likely to be admitted with conditions such as bronchiolitis, a common illness which causes infants to cough and wheeze.

She says 800 children a year are admitted to Starship with preventable skin infections.

"We live in a First World country, however we have a lot of Third World conditions. Those include things like our very high pneumonia rate; bronchiectasis - a chronic moist productive cough which you get from viral infections when you are little. That causes ongoing lung damage and people die earlier.

"Similarly rheumatic fever. In most developed countries around the world they hardly ever see rheumatic fever and we here in New Zealand see about 100 children a year with a new diagnosis of rheumatic fever and about five of those would come from the Tamaki-Glen Innes area. That's a preventable disease with long-term complications."

Public health nurse Lorrelle Breen has visited schools in poorer areas of the east for more than 20 years.

She says the needs of decile one school pupils differ vastly to those of children from neighbouring decile two schools.

"In poor schools things like obesity feature really highly, skin problems are huge. That's stuff like school sores, scabies, head lice. You do get those things in higher deciles but in the lower deciles you have struggles with finances, parental support, a lot of absenteeism.

"They also have some mental health issues, hygiene, bit of child protection, housing comes up a lot and sometimes addictions such as smoking and alcohol.

"Even working in that area for 20 years I was still surprised that there was such a difference. I think schools get overwhelmed with the amount of need in those low decile schools and they have to be far more than teachers."

Dr Laversha says a mixture of sub-standard housing issues, over-nutrition or under-nutrition, exposure to tobacco smoke and health literacy could be to blame for the grim statistics.

"Families from more disadvantaged neighbourhoods don't have sufficient money to send their kids to school with a full tummy. Many of us can not even imagine what that would be like ... knowing when you need to seek help for a cut or a scratch, when you need to seek help for a sore throat, and your ability to be able to navigate the health systems is a challenge.

"Then there's being able to pay for the antibiotics."

She says research on Auckland families shows poverty is not only a lack of money.

"For sole-parent families children could have poorly fitting clothes or they don't have shoes so they couldn't go on school outings.

"They shared beds, they postponed doctors visits because of cost.

"If you're born into a poor family you're more likely to have those issues as you get older. There's a huge intergenerational cycle so we absolutely have to stop it."